Rates of Osteoporosis Management and Secondary Preventative Treatment After Primary Fragility Fractures

Area of Science:

• Gerontology
• Orthopedics
• Public Health

Background:

• Fragility fractures are key indicators of osteoporosis.
• Existing research shows inadequate osteoporosis evaluation and treatment post-fracture.
• This study addresses the need to quantify fracture incidence and subsequent management rates.

Purpose of the Study:

• To determine the incidence of primary fragility fractures in the U.S.
• To assess osteoporosis screening and management rates before and after these fractures.

Main Methods:

• Retrospective review of the PearlDiver database using ICD-9/ICD-10 and CPT codes.
• Inclusion of patients aged 60-80 with hip, wrist, spine, pelvis, or humerus fragility fractures.
• Assessment of dual x-ray absorptiometry (DXA) screening and pharmacotherapy rates 2 years pre- and post-fracture.

Main Results:

• Identified 48,668 primary fragility fractures; 25.8% had prior osteoporosis management.
• Among those without prior management, 19% were diagnosed with osteoporosis and 18.4% received DXA/pharmacotherapy post-fracture.
• Patients with osteoporosis diagnosis were more likely to receive management (OR 11.55), while males were less likely (OR 0.23).

Conclusions:

• Osteoporosis evaluation and management post-fragility fracture are significantly low.
• Less than one-third of patients received prior evaluation/treatment.
• Fewer than 20% of patients without pre-fracture management received subsequent screening or treatment.